In Vitro Microleakage Comparison of Flowable Nanocomposites and Conventional Materials Used in Pit and Fissure Sealant Therapy
,
Abstract
Objectives: Pit and fissure sealants are recognized as an effective preventive approach in pediatric dentistry. Composite resin is the most commonly used sealant material. Adding nanoparticles to composite resin could result in production of flowable composite with higher mechanical properties and better flowability than previous sealants. This study aimed to compare the microleakage of a flowable nanocomposite and materials conventionally used as pit and fissure sealants.
Materials and Methods: A total of 185 extracted mandibular third molar teeth were selected and randomly divided into 5 groups (n=36): flowable nanocomposite, flowable composite, filled sealants, nano-filled sealants, and unfilled sealants. Five teeth were reserved for examination under a scanning electron microscope (SEM). The samples were thermocycled (5-55°C, 1-minute dwell time) for 1000 cycles and immersed in 0.2% fuchsine solution for 24 hours. Teeth were sectioned buccolingually. Microleakage was assessed qualitatively and quantitatively by means of dye penetration and SEM. Data were analyzed using chi-square, Kruskal-Wallis, and Bonferroni-corrected Mann-Whitney U tests.
Results: Qualitative microleakage assessment showed that flowable composite and nanofilled flowable composite had almost no microleakage (P<0.001). Regarding quantitative scores, the nanofilled flowable composite and unfilled fissure sealant showed the lowest and the highest rate of microleakage, respectively. No statistically significant difference was found between the two flowable composites (P=0.317). Filled resin-based sealant had significantly lower microleakage than unfilled resin-based sealant (P<0.001).
Conclusion: Use of flowable and nanofilled flowable composites (but not unfilled resin-based fissure sealant) is recommended for sealing of pits and fissures of molars
1. Wright JT, Crall JJ, Fontana M, Gillette EJ, Nový BB, Dhar V, et al. Evidence-based clinical practice guideline for the use of pit-and-fissure sealants. J Am Dent Assoc. 2016 Aug; 147(8):672-82.
2. Chen X, Du MQ, Fan MW, Mulder J, Huysmans MCDNJM, Frencken JE. Caries-preventive effect of sealants produced with altered glass-ionomer materials, after 2 years. Dent Mater. 2012 May; 28(5):554-60.
3. Makhija SK, Gilbert GH, Funkhouser E, Bader JD, Gordan VV, Rindal DB, et al. The prevalence of questionable occlusal caries: findings from the Dental Practice-Based Research Network. J Am Dent Assoc. 2012 Dec; 143(12):1343-50.
4. Demirci M, Tuncer S, Yuceokur AA. Prevalence of caries on individual tooth surfaces and its distribution by age and gender in university clinic patients. Eur J Dent. 2010 Jul; 4(3):270-9.
5. Dimitrov E, Georgieva M, Andreeva R, Dimova-Gabrovska М, Arnautska H. Caries prevalence among 5-7-year-old children in northeast Bulgaria. J of IMAB. 2017 Jul; 23(3):1633-6.
6. Pereira AC, Pardi V, Mialhe FL, Meneghim Mde C, Ambrosano GM. A 3-year clinical evaluation of glass-ionomer cements used as fissure sealants. Am J Dent. 2003; 16(1):23-7.
7. Simonsen RJ, Neal RC. A review of the clinical application and performance of pit and fissure sealants. Aust Dent J. 2011 Jun; 56:45-58.
8. Simonsen RJ. Pit and fissure sealant: review of the literature. Pediatr Dent. 2002 Sep; 24(5):393-414.
9. Naaman R, El-Housseiny AA, Alamoudi N. The Use of Pit and Fissure Sealants-A Literature Review. Dent J (Basel). 2017 Dec 11; 5(4).
10. Pardi V, Sinhoreti MAC, Pereira AC, Ambrosano GMB, Meneghim MdC. In Vitro evaluation of microleakage of different materials used as pit-and-fissure sealants. Braz Dent J. 2006; 17(1):49-52.
11. Ahovuo-Saloranta A, Hiiri A, Nordblad A, Mäkelä M, Worthington HV. Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database Syst Rev. 2008 Oct; 2(1):1-12.
12. Deery C. Strong evidence for the effectiveness of resin based sealants. Evid Based Dent. 2013 Sep; 14(3):69-70.
13. Hiiri A, Ahovuo-Saloranta A, Nordblad A, Mäkelä M. Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents. Cochrane Database Syst Rev. 2010(3):CD003067-CD.
14. Mickenautsch S, Yengopal V. Caries-preventive effect of high-viscosity glass ionomer and resin-based fissure sealants on permanent teeth: A systematic review of clinical trials. PLoS One. 2016 Jan; 11(1):e0146512.
15. Mickenautsch S, Yengopal V. Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: An update of systematic review evidence. BMC Res Notes. 2011 Dec; 4(1):22.
16. Haznedaroglu E, Guner S, Duman C, Mentes A. A 48-month randomized controlled trial of caries prevention effect of a one-time application of glass ionomer sealant versus resin sealant. Dent Mater J. 2016 May; 35(3): 532-8.
17. Sly GE, Missana LR, Nieva N, Kaplan AE. Ex vivo microleakage comparison between glass ionomers used as pit and fissure sealants. Acta Odontol Latinoam. 2015 Aug; 28(2):132-7.
18. Singla T, Pandit IK, Srivastava N, Gugnani N, Gupta M. An evaluation of microleakage of various glass ionomer based restorative materials in deciduous and permanent teeth: An in vitro study. Saudi Dent J. 2012 Jan; 24(1):35-42.
19. Ovrebo RC, Raadal M. Microleakage in fissures sealed with resin or glass ionomer cement. Scand J Dent Res. 1990 Feb; 98(1): 66-9.
20. Theodoridou-Pahini S, Tolidis K, Papadogiannis Y. Degree of microleakage of some pit and fissure sealants: an in vitro study. Int J Paediatr Dent. 1996 Sep; 6(3):173-6.
21. Singh HS, Anuradha P. Comparison of microleakage of glass ionomer sealant in etched and non etched fissure enamel with resin based sealant - An in vitro study. Int J Oral Health Med Res. 2016; 2(6):51-3.
22. Pakdel A, Partovi S, Sadra E, Rezvani S, Valayi N, Kalantar Motamedi M. Effect of different enamel preparation methods on microleakage of fissure sealant: An in vitro study. J Dent Sch. 2014 Nov; 32(4):216-21.
23. Tehrani MH, Birjandi N, Nasr E, Shahtusi M. Comparison of microleakage of two materials used as fissure sealants with different methods: An in vitro study. Int J Prev Med. 2014 Feb; 5(2):171-5.
24. Bagherian A, Akbari M, Rezaeian M, Ansari G. Microleakage assessment of fissure sealant following fissurotomy bur or pumice prophylaxis use before etching. Dent Res J. 2013 Sep; 10(5):643-6.
25. Lupi-Pegurier L, Bertrand MF, Genovese O, Rocca JP, Muller-Bolla M. Microleakage of resin-based sealants after Er:YAG laser conditioning. Lasers Med Sci. 2007 Sep; 22(3):183-8.
26. Shafiei L, Mojiri P, Ghahraman Y, Rakhshan V. Microleakage of a self-adhesive class V composite on primary and permanent dentitions. J Contemp Dent Pract. 2013 May; 14(3):461-7.
27. Cehreli ZC, Gungor HC. Quantitative microleakage evaluation of fissure sealants applied with or without a bonding agent: results after four-year water storage in vitro. J Adhes Dent. 2008 Sep; 10(5):379-84.
28. Khogli AE, Cauwels R, Vercruysse C, Verbeeck R, Martens LUC. Microleakage and penetration of a hydrophilic sealant and a conventional resin-based sealant as a function of preparation techniques: a laboratory study. Int J Paediatr Dent. 2013 Jan; 23(1):13-22.
29. Krause F, Jepsen S, Braun A. Comparison of two laser fluorescence devices for the detection of occlusal caries in vivo. Eur J Oral Sci. 2007 Aug; 115(4):252-6.
30. Duangthip D, Lussi A. Variables contributing to the quality of fissure sealants used by general dental practitioners. Oper Dent. 2003; 28(6):756-64.
31. Gateva N. Hybrid layer thickness in primary and permanent teeth- A comparison between total etch adheisves. J of IMAB 2012 May; 18(2):191-9.
32. Singh S, Pandey RK. An evaluation of nanocomposites as pit and fissure sealants in child patients. J Indian Soc Pedod Prev Dent. 2011 Oct; 29(4):294-9.
33. Eliades A, Birpou E, Eliades T, Eliades G. Self-adhesive restoratives as pit and fissure sealants: A comparative laboratory study. Dent Mater. 2013 Jul; 29(7):752-62.
34. Mejàre I, Lingström P, Petersson LG, Holm AK, Twetman S, Källestål C, et al. Caries‐preventive effect of fissure sealants: a systematic review. Acta Odontol Scand. 2003 Jan; 61(6):321-30.
35. Feigal RJ. The use of pit and fissure sealants. Pediatr Dent. 2002; 24(5):415-22.
36. Yengopal V, Mickenautsch S, Bezerra AC, Leal SC. Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: a meta analysis. J Oral Sci. 2009; 51(3):373-82.
37. Handelman SL, Washburn F, Wopperer P. Two-year report of sealant effect on bacteria in dental caries. J Am Dent Assoc. 1976 Nov; 93(5):967-70.
38. Mertz-Fairhurst E. Current status of sealant retention and caries prevention. J Dent Educ. 1984; 48(2):18-26.
39. Khanna R, Pandey RK, Singh N, Agarwal A. A comparison of enameloplasty sealant technique with conventional sealant technique: A scanning electron microscope study. J Indian Soc Pedod Prev Dent. 2009 Jul; 27(3):158-63.
40. Salama FS, Al-Hammad NS. Marginal seal of sealant and compomer materials with and without enameloplasty. Int J Paediat Dent. 2002 Jan; 12(1):39-46.
41. Hannig M, Gräfe A, Atalay S, Bott B. Microleakage and SEM evaluation of fissure sealants placed by use of self-etching priming agents. J Dent. 2004 Jan; 32(1):75-81.
42. Kitchens DH. The economics of pit and fissure sealants in preventive dentistry: a review. J Contemp Dent Pract. 2005 Aug; 6(3):95-103.
43. Tulunoglu O, Bodur H, Uctasli M, Alacam A. The effect of bonding agents on the microleakage and bond strength of sealant in primary teeth. J Oral Rehab. 1999 May; 26(5):436-41.
44. Pérez-Lajarín L, Cortes-Lillo O, García-Ballesta C, Cózar-Hidalgo A. Marginal microleakage of two fissure sealants: a comparative study. J Dent Child. 2003 May; 70(1):24-8.
45. Alani AH, Toh CG. Detection of microleakage around dental restorations: a review. Oper Dent. 1997 Jul; 22(4):173-85.
46. Jacobs MS, Windeler AS. An investigation of dental luting cement solubility as a function of the marginal gap. J Prosthet Dent. 1991 Mar; 65(3):436-42.
47. Baldissara P, Comin G, Martone F, Scotti R. Comparative study of the marginal microleakage of six cements in fixed provisional crowns. J Prosthet Dent. 1998 Oct; 80(4):417-22.
48. Raskin A, Tassery H, D Hoore W, Gonthier S, Vreven J, Degrange M, et al. Influence of the number of sections on reliability of in vitro microleakage evaluations. Am J Dent. 2003 Jun; 16(3):207-10.
49. Gillet D, Nancy J, Dupuis V, Dorignac G. Microleakage and penetration depth of three types of materials in fissure sealant: self-etching primer vs etching: an in vitro study. J Clin Pediat Dent. 2003 Jan; 26(2):175-8.
50. Fernandes KS, Chalakkal P, de Ataide IdN, Pavaskar R, Fernandes PP, Soni H. A comparison between three different pit and fissure sealants with regard to marginal integrity. J Conserv Dent. 2012 Apr; 15(2):146-50.
51. Flanagan RAW, Pearson GJ. Evaluation of dye penetrations around two resin-based materials used as fissure sealants. Biomaterials. 1988 Sep; 9(5):460-2.
52. Dukić W, Lulić Dukić O, Milardović S, Vindakijević Ž. Clinical comparison of flowable composite to other fissure sealing materials–a 12 months study. Coll Antropol. 2007 Dec; 31(4):1019-24.
53. Bahrololoomi Z, Soleymani A, Heydari Z. In vitro comparison of microleakage of two materials used as pit and fissure sealants. J Dent Res Dent Clin Dent Prospects. 2011; 5(3):83-6.
54. Kwon HB, Park KT. SEM and microleakage evaluation of 3 flowable composites as sealants without using bonding agents. Pediat Dent. 2006 Jan; 28(1):48-53.
2. Chen X, Du MQ, Fan MW, Mulder J, Huysmans MCDNJM, Frencken JE. Caries-preventive effect of sealants produced with altered glass-ionomer materials, after 2 years. Dent Mater. 2012 May; 28(5):554-60.
3. Makhija SK, Gilbert GH, Funkhouser E, Bader JD, Gordan VV, Rindal DB, et al. The prevalence of questionable occlusal caries: findings from the Dental Practice-Based Research Network. J Am Dent Assoc. 2012 Dec; 143(12):1343-50.
4. Demirci M, Tuncer S, Yuceokur AA. Prevalence of caries on individual tooth surfaces and its distribution by age and gender in university clinic patients. Eur J Dent. 2010 Jul; 4(3):270-9.
5. Dimitrov E, Georgieva M, Andreeva R, Dimova-Gabrovska М, Arnautska H. Caries prevalence among 5-7-year-old children in northeast Bulgaria. J of IMAB. 2017 Jul; 23(3):1633-6.
6. Pereira AC, Pardi V, Mialhe FL, Meneghim Mde C, Ambrosano GM. A 3-year clinical evaluation of glass-ionomer cements used as fissure sealants. Am J Dent. 2003; 16(1):23-7.
7. Simonsen RJ, Neal RC. A review of the clinical application and performance of pit and fissure sealants. Aust Dent J. 2011 Jun; 56:45-58.
8. Simonsen RJ. Pit and fissure sealant: review of the literature. Pediatr Dent. 2002 Sep; 24(5):393-414.
9. Naaman R, El-Housseiny AA, Alamoudi N. The Use of Pit and Fissure Sealants-A Literature Review. Dent J (Basel). 2017 Dec 11; 5(4).
10. Pardi V, Sinhoreti MAC, Pereira AC, Ambrosano GMB, Meneghim MdC. In Vitro evaluation of microleakage of different materials used as pit-and-fissure sealants. Braz Dent J. 2006; 17(1):49-52.
11. Ahovuo-Saloranta A, Hiiri A, Nordblad A, Mäkelä M, Worthington HV. Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database Syst Rev. 2008 Oct; 2(1):1-12.
12. Deery C. Strong evidence for the effectiveness of resin based sealants. Evid Based Dent. 2013 Sep; 14(3):69-70.
13. Hiiri A, Ahovuo-Saloranta A, Nordblad A, Mäkelä M. Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents. Cochrane Database Syst Rev. 2010(3):CD003067-CD.
14. Mickenautsch S, Yengopal V. Caries-preventive effect of high-viscosity glass ionomer and resin-based fissure sealants on permanent teeth: A systematic review of clinical trials. PLoS One. 2016 Jan; 11(1):e0146512.
15. Mickenautsch S, Yengopal V. Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: An update of systematic review evidence. BMC Res Notes. 2011 Dec; 4(1):22.
16. Haznedaroglu E, Guner S, Duman C, Mentes A. A 48-month randomized controlled trial of caries prevention effect of a one-time application of glass ionomer sealant versus resin sealant. Dent Mater J. 2016 May; 35(3): 532-8.
17. Sly GE, Missana LR, Nieva N, Kaplan AE. Ex vivo microleakage comparison between glass ionomers used as pit and fissure sealants. Acta Odontol Latinoam. 2015 Aug; 28(2):132-7.
18. Singla T, Pandit IK, Srivastava N, Gugnani N, Gupta M. An evaluation of microleakage of various glass ionomer based restorative materials in deciduous and permanent teeth: An in vitro study. Saudi Dent J. 2012 Jan; 24(1):35-42.
19. Ovrebo RC, Raadal M. Microleakage in fissures sealed with resin or glass ionomer cement. Scand J Dent Res. 1990 Feb; 98(1): 66-9.
20. Theodoridou-Pahini S, Tolidis K, Papadogiannis Y. Degree of microleakage of some pit and fissure sealants: an in vitro study. Int J Paediatr Dent. 1996 Sep; 6(3):173-6.
21. Singh HS, Anuradha P. Comparison of microleakage of glass ionomer sealant in etched and non etched fissure enamel with resin based sealant - An in vitro study. Int J Oral Health Med Res. 2016; 2(6):51-3.
22. Pakdel A, Partovi S, Sadra E, Rezvani S, Valayi N, Kalantar Motamedi M. Effect of different enamel preparation methods on microleakage of fissure sealant: An in vitro study. J Dent Sch. 2014 Nov; 32(4):216-21.
23. Tehrani MH, Birjandi N, Nasr E, Shahtusi M. Comparison of microleakage of two materials used as fissure sealants with different methods: An in vitro study. Int J Prev Med. 2014 Feb; 5(2):171-5.
24. Bagherian A, Akbari M, Rezaeian M, Ansari G. Microleakage assessment of fissure sealant following fissurotomy bur or pumice prophylaxis use before etching. Dent Res J. 2013 Sep; 10(5):643-6.
25. Lupi-Pegurier L, Bertrand MF, Genovese O, Rocca JP, Muller-Bolla M. Microleakage of resin-based sealants after Er:YAG laser conditioning. Lasers Med Sci. 2007 Sep; 22(3):183-8.
26. Shafiei L, Mojiri P, Ghahraman Y, Rakhshan V. Microleakage of a self-adhesive class V composite on primary and permanent dentitions. J Contemp Dent Pract. 2013 May; 14(3):461-7.
27. Cehreli ZC, Gungor HC. Quantitative microleakage evaluation of fissure sealants applied with or without a bonding agent: results after four-year water storage in vitro. J Adhes Dent. 2008 Sep; 10(5):379-84.
28. Khogli AE, Cauwels R, Vercruysse C, Verbeeck R, Martens LUC. Microleakage and penetration of a hydrophilic sealant and a conventional resin-based sealant as a function of preparation techniques: a laboratory study. Int J Paediatr Dent. 2013 Jan; 23(1):13-22.
29. Krause F, Jepsen S, Braun A. Comparison of two laser fluorescence devices for the detection of occlusal caries in vivo. Eur J Oral Sci. 2007 Aug; 115(4):252-6.
30. Duangthip D, Lussi A. Variables contributing to the quality of fissure sealants used by general dental practitioners. Oper Dent. 2003; 28(6):756-64.
31. Gateva N. Hybrid layer thickness in primary and permanent teeth- A comparison between total etch adheisves. J of IMAB 2012 May; 18(2):191-9.
32. Singh S, Pandey RK. An evaluation of nanocomposites as pit and fissure sealants in child patients. J Indian Soc Pedod Prev Dent. 2011 Oct; 29(4):294-9.
33. Eliades A, Birpou E, Eliades T, Eliades G. Self-adhesive restoratives as pit and fissure sealants: A comparative laboratory study. Dent Mater. 2013 Jul; 29(7):752-62.
34. Mejàre I, Lingström P, Petersson LG, Holm AK, Twetman S, Källestål C, et al. Caries‐preventive effect of fissure sealants: a systematic review. Acta Odontol Scand. 2003 Jan; 61(6):321-30.
35. Feigal RJ. The use of pit and fissure sealants. Pediatr Dent. 2002; 24(5):415-22.
36. Yengopal V, Mickenautsch S, Bezerra AC, Leal SC. Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: a meta analysis. J Oral Sci. 2009; 51(3):373-82.
37. Handelman SL, Washburn F, Wopperer P. Two-year report of sealant effect on bacteria in dental caries. J Am Dent Assoc. 1976 Nov; 93(5):967-70.
38. Mertz-Fairhurst E. Current status of sealant retention and caries prevention. J Dent Educ. 1984; 48(2):18-26.
39. Khanna R, Pandey RK, Singh N, Agarwal A. A comparison of enameloplasty sealant technique with conventional sealant technique: A scanning electron microscope study. J Indian Soc Pedod Prev Dent. 2009 Jul; 27(3):158-63.
40. Salama FS, Al-Hammad NS. Marginal seal of sealant and compomer materials with and without enameloplasty. Int J Paediat Dent. 2002 Jan; 12(1):39-46.
41. Hannig M, Gräfe A, Atalay S, Bott B. Microleakage and SEM evaluation of fissure sealants placed by use of self-etching priming agents. J Dent. 2004 Jan; 32(1):75-81.
42. Kitchens DH. The economics of pit and fissure sealants in preventive dentistry: a review. J Contemp Dent Pract. 2005 Aug; 6(3):95-103.
43. Tulunoglu O, Bodur H, Uctasli M, Alacam A. The effect of bonding agents on the microleakage and bond strength of sealant in primary teeth. J Oral Rehab. 1999 May; 26(5):436-41.
44. Pérez-Lajarín L, Cortes-Lillo O, García-Ballesta C, Cózar-Hidalgo A. Marginal microleakage of two fissure sealants: a comparative study. J Dent Child. 2003 May; 70(1):24-8.
45. Alani AH, Toh CG. Detection of microleakage around dental restorations: a review. Oper Dent. 1997 Jul; 22(4):173-85.
46. Jacobs MS, Windeler AS. An investigation of dental luting cement solubility as a function of the marginal gap. J Prosthet Dent. 1991 Mar; 65(3):436-42.
47. Baldissara P, Comin G, Martone F, Scotti R. Comparative study of the marginal microleakage of six cements in fixed provisional crowns. J Prosthet Dent. 1998 Oct; 80(4):417-22.
48. Raskin A, Tassery H, D Hoore W, Gonthier S, Vreven J, Degrange M, et al. Influence of the number of sections on reliability of in vitro microleakage evaluations. Am J Dent. 2003 Jun; 16(3):207-10.
49. Gillet D, Nancy J, Dupuis V, Dorignac G. Microleakage and penetration depth of three types of materials in fissure sealant: self-etching primer vs etching: an in vitro study. J Clin Pediat Dent. 2003 Jan; 26(2):175-8.
50. Fernandes KS, Chalakkal P, de Ataide IdN, Pavaskar R, Fernandes PP, Soni H. A comparison between three different pit and fissure sealants with regard to marginal integrity. J Conserv Dent. 2012 Apr; 15(2):146-50.
51. Flanagan RAW, Pearson GJ. Evaluation of dye penetrations around two resin-based materials used as fissure sealants. Biomaterials. 1988 Sep; 9(5):460-2.
52. Dukić W, Lulić Dukić O, Milardović S, Vindakijević Ž. Clinical comparison of flowable composite to other fissure sealing materials–a 12 months study. Coll Antropol. 2007 Dec; 31(4):1019-24.
53. Bahrololoomi Z, Soleymani A, Heydari Z. In vitro comparison of microleakage of two materials used as pit and fissure sealants. J Dent Res Dent Clin Dent Prospects. 2011; 5(3):83-6.
54. Kwon HB, Park KT. SEM and microleakage evaluation of 3 flowable composites as sealants without using bonding agents. Pediat Dent. 2006 Jan; 28(1):48-53.
| Files | ||
| Issue | Vol 16, No 1 (2019) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v16i1.1105 | |
| Keywords | ||
| Dental Leakage Pit and Fissure Sealants Composite Resins Microscopy Electron Scanning | ||
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How to Cite
1.
Arastoo S, Behboudi A, Rakhshan V. In Vitro Microleakage Comparison of Flowable Nanocomposites and Conventional Materials Used in Pit and Fissure Sealant Therapy. Front Dent. 2019;16(1):21-30.
